Endocrine Abstracts

Aim: Recent studies reported a wide range in baseline and peak cortisol responses to surgery. We report the results of cosyntropin stimulation testing following unilateral adrenalectomy for non-steroid secreting lesions.Methods: Data of 36 patients who underwent cosyntropin stimulation testing on the second day post unilateral adrenalectomy were collected retrospectively. None of the patients had clinical signs of hypercortisolism. No patient received pr...

Primary Hyperparathyroidism (pHPT) affects approximately 1:2000 women under 40 years of age, so pHPT in pregnancy is uncommon. It is associated with significantly increased risks of morbidity for mother and foetus. Conventionally, surgery is recommended, ideally early in the second trimester. A 31-year-old woman attended the Accident and Emergency department at 26+4 weeks of her third gestation, with severe loin pain and fever. She had a past medical history of pyelonephritis....

Phaeochromocytoma and paragangliomas (PH/PG) are rare neuroendocrine tumours. Prediction of aggressive tumour behaviour remains a major challenge. The Phaeochromocytoma of the Adrenal gland Scaled Score (PASS) is used to separate benign from malignant lesions with a score > 4 showing potential for biologically aggressive behaviour. Pre-operatively, MIBG together with CT/MRI remain the diagnostic radiological gold standard.We report a 68-year-old fema...

We describe a case of a male who presented to a rheumatologist with hypercalceamia at the age of 22 in 1995. Investigations were incomplete and he was lost to follow up. He was referred to a general surgeon in 2002 as another blood test had showed hypercalcaemia of 2.8 mmol/l (2.2–2.6), parathyroid hormone 9.5 pmol/l (1.6–6.9). A spot urine calcium/creatinine excretion ratio was 0.014. It was felt he probably had primary hyperparathyroidism and he was managed conserv...

Primary hyperparathyroidism (PHPT) is a common condition, affecting approximately 1% of the general population. In women of childbearing age, the correct diagnosis and management is particularly important since PHPT is associated with miscarriage, pre-eclampsia, intrauterine growth restriction, preterm delivery and postpartum neonatal hypocalcaemia. We describe a case series of six women diagnosed with PHPT and their management during pregnancy. In four cases, the PH...

Parathyroid cysts are rare, usually asymptomatic and typically present as a neck lump. They are most commonly detected in middle-aged women and can occasionally present with compressive symptoms. True parathyroid cysts are non-functional and benign in nature, allowing a more conservative approach to their management in many patients. We present the case of an 82-year-old lady with a past medical history of a presumed parathyroid cyst which was drained by the ENT surgeons. Thre...

Background: Chromaffin cell tumours are rare but potentially curable endocrine tumours. These tumours may be sporadic or familial in nature. Biochemical tests are normally performed initially, followed by radiological investigation.Aim: To assess the correlation of biochemical and radiological investigations with histologically proven chromaffin-cell tumours in patients with sporadic and familial disease.Methods: We retrospectively...

A 36-year-old man, presenting to his GP with severe intermittent headaches, was found to have a blood pressure of 210/110 mmHg. He had been diagnosed with familial adenomatous polyposis (FAP) in early childhood, and had had a total colectomy with ileo-rectal anastamosis at the age of 17. Routine surveillance CT imaging the following month revealed an incidental finding of bilateral adrenal masses (right 4×2 cm, left 2.7×2.9 cm).On assessment in...

Background: Hypercalcaemia is defined as an elevated serum calcium level above 2.6 mmol/l and occurs in 1 in 1000 of the population. It commonly results from primary hyperparathyroidism (PHP) which is usually treated with parathyroidectomy. A less common cause of hypercalcaemia is familial hypocalciuric hypercalcaemia (FHH) which is caused by mutations inactivating the calcium-sensing receptor; however FHH is relatively benign and requires no treatment. It is clearly important...

Introduction: Adrenocortical carcinoma (ACC) is an uncommon aggressive malignancy. Despite surgical resection, recurrence rates are high. Two areas of contention currently involve treatment of ACC: the role of laparoscopic surgery in removal of large, potentially malignant tumours and the role of Mitotane. We present a case of a large adrenal tumour, later confirmed as ACC, where initially laparoscopic adrenalectomy was considered, and adjuvant Mitotane has been given despite ...